The elective in
infectious diseases is designed to provide house officers with the knowledge
and skills needed to diagnose and treat a wide variety of bacterial diseases,
as well as fungal and viral illnesses. Patients are very diverse
ethnically and socioeconomically, and are representative of the neighboring
Montefiore communities.

Residents work in teams
under the supervision of the infectious diseases fellow and
attending. The attending physician is responsible for supervision of
all patient care.

a)General Infectious Diseases (I.D.) elective: one block of 2-4 weeks (4 weeks preferred),
with a 24/7 coverage by the consultation service. The elective is
available to all Internal Medicine PGY-2’s and PGY-3’s. If a PGY-1 resident wishes to rotate, it is
preferred that she or he be in the second half of the intern year

b)ICT (Immunocompromised Host and Transplant) I.D.
elective: One block of 2-4 weeks,
available for PGY-2 residents in the second half of their year and PGY-3
residents. It is recommended for
residents who have already spent at least two weeks on the General I.D.
service, or those with a particular interest in solid organ transplantation or
hematological malignancies.

-Medical Knowledge: Use discussions during daily rounds; use
literature and reference sources to increase knowledge base, to learn
guidelines apply for patient management; acquire basic knowledge in the areas
of underlying pathophysiology and the clinical aspects of infections.

-Professionalism: establish trust with critically ill
patients with infections and their families; to participate in
teamwork. Exhibit honesty, reliability, and responsibility in
patient care; demonstrate respect for patients and staff; attend conferences.

-Interpersonal Skills: Learn to write understandable notes;
listen to patients and staff and communicate; work effectively as a member of
the health care team.

-Practice Based Learning and Improvement: Recognize limitations of knowledge;
to use literature to improve practice patterns; accept feedback and change
behavior; ask for help when needed; incorporate outcomes of patients with
infections to improve outcomes in the future.

-System Based Practice: be an advocate for patients with
infections; accept and try to apply necessary devised guidelines; develop
understanding about the health care systems/structure and how it relates to
patients with infections.

patient’s other medical conditions and their
impact on the immune system; begin to recognize the acuity levels of illness; list
the indications, contraindications and risks of drainage of abscesses and other
invasive procedures required to make microbiologic diagnoses; work with all
providers to provide patient focused care.

-Medical Knowledge: Use literature and reference sources to
increase knowledge base in infectious diseases; demonstrate basic knowledge in
the areas of underlying pathophysiology and the clinical aspects of infectious
diseases states; apply knowledge in the treatment of patients.

-Professionalism: Establish trust with patients and
staff; exhibit honesty, reliability and responsibility in patient care;
demonstrate respect for patients and staff; work to fulfill the needs of
patients; accept assignments graciously; attend conferences.

-Interpersonal Skills: Write understandable notes and
consultation reports; improve ability to listen to patients and staff and
communicate verbally and nonverbally in a productive manner; work effectively
as a member of the health care team.

-Practice Based Learning and Improvement: Recognize limitations of knowledge;
use references and literature to improve practice patterns; accept feedback and
change behavior; ask for help when needed. Do not overstep
responsibilities.

-System Based Practice: be an advocate for patients with
infections; accept and try to apply necessary devised guidelines; to develop
understanding about the health care systems and structure and how they relates
to patients with infections.

PGY3:

-Patient Care: Prioritize the daily work load of patients with
infections and supervise the junior house staff appropriately; recognize the
relative significance of a patients’ medical conditions and their impact on the
immune system; recognize the acuity levels of illness; fully understand the
indications, contraindications and risks of common and uncommon procedures;
discuss risks/benefits native of patient’s with specialists.

-Medical Knowledge: Use literature and reference sources to
increase knowledge base and share knowledge with junior house staff;
demonstrate sophisticated knowledge in the areas of underlying pathophysiology
an the clinical aspects of simple and complicated disease states; apply
knowledge in the treatment of patients.

-Professionalism: Establish trust with patients and
staff; exhibit honesty, reliability and responsibility in patient care;
demonstrate respect for patients and staff and junior house staff who you are
supervising; work with team to fulfill the needs of patients; lead health care
team in patient care; understand limitations and ask supervisors for help when
indicated; accept assignments graciously; attend conferences.

-Interpersonal Skills: Write understandable notes and
consultation reports; improve ability to listen to patients and staff and
communicate verbally and nonverbally in a productive manner; work effectively
as a member of the health care team, and be an example for junior house
officers.

-Practice Based Learning and Improvement: Recognize limitations of knowledge;
use references and literature to improve practice patterns; accept feedback and
change behavior; ask for help when needed; learn from the outcomes of patients
with infections and alter practice patterns to improve outcomes in the future;
aid junior house staff in evaluating their practice patterns.

-System Based Practice: Advocate for patients; develop a
sophisticated understanding about the health care system/structure and develop
mechanisms to utilize ancillary services to benefit patients.

II. Areas
Covered During The Infectious Diseases Elective

1)Principles, physiology and basic sciences.

2)Practical skills unique to infectious diseases, including but not
limited to: fever workup, examination of
wounds and intravascular catheters, interpretation of Gram stains,
interpretations of antibiograms, interpretation of drug levels.

3)Approach to presenting complaints and problems.

4)Specific diagnosis in infectious diseases: including
recommendation of proper culture techniques to allow the microbiology
laboratories to isolate the infecting micro-organisms, and recommendation of
correct specific diagnostic tests

5)Treatment modalities: rational use of antimicrobial agents and
non-pharmacologic means of treatment such as wound care.

6)Technical skills, such as handwashing, sterile techniques, and
changing dressings.

7)Emergencies, such as recognition of acute bacterial meningitis.

8) Ability
to access, interpret, and apply guidelines for the diagnosis and treatment of
frequently-encountered infections

9) ICT ID
elective: Understanding how the
nature and degree of immunosuppression changes the infectious differential
diagnosis; learning the interactions of antibiotics with immunosuppressive
drugs

III Schedule
Of Activities

1)Attending Rounds Monday
to Friday, every afternoon

2)I.D. Grand Rounds Wednesday 8:30 to 10:00 A.M.

3)I.D. Core Curriculum Lectures Wednesday 7:30 to 8:30 A.M.

4)Research/Basic Science Seminar Wednesdays 8:30 to 10:00 AM

5)Journal Club occasional
Wednesdays 9:00 to 10:00 A.M.

6)M&M case presentations occasional Wednesdays 9:00 to
10:00 A.M.

7)Medical Grand Rounds Thursday (8-9 AM Weiler, 12:00-1:15 PM Moses)

IV. References

a)General ID elective

Before beginning the
rotation, residents should be aware that the majority of diagnosis and
management questions can be answered by referring to the Practice Guidelines
from the Infectious Diseases Society of America. These guidelines are available at

The
house officers are evaluated continuously during their two -four weeks
of service in the infectious diseases elective with continuous feedback to
the house officers. The final evaluation is completed through www.new-innov.com and the results
are discussed in a meeting with the house officers, who are evaluated in their
overall clinical competence with the following categories: clinical judgment,
medical knowledge, clinical skills, humanistic qualities, professionalism,
patient care and ability to incorporate feedback and improve.